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Clinical Laboratory Equipment 1 م ي ح ر ل ا ن م ح ر ل له ا م الس ب ه ودي سع ل ا ه ي ب ر لع ا كه ل م م ل ا ه ي ق ي ب ط ت ل ا ه ي ب لط وم ا ل ع ل ما س ق ي ل عا ل ما ي عل ي ل ا ارة7 ور ه ي ب ط ة7 ز ه صا ص7 خ ت ود ع سC لك م ل ا عه ام ج ه ي ك ي7 ن ي كلL الإ رات ب ت7 خ م ل ا ة7 ز ه ا210 7 ر ج= ا7 اض ري ل ا عي م ت ج م ل ا ه ي ل كإ= ول ى ال س الدرا ل ص7 ف ل ا34 - 35

Clinical Laboratory Equipment MASH 210, A. Eshra, Spring 2013/14, 1 st Semester 1 بسم الله الرحمن الرحيم المملكة العربية السعوديةقسـم العلوم

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Page 1: Clinical Laboratory Equipment MASH 210, A. Eshra, Spring 2013/14, 1 st Semester 1 بسم الله الرحمن الرحيم المملكة العربية السعوديةقسـم العلوم

Clinical LaboratoryEquipment

MASH 210, A. Eshra, Spring 2013/14, 1st Semester 1

الرحيم الرحمن الله بسم

العربية المملكةالسعودية

الطبيـة العلوم قسـمالتطبيقيـة

التعليـــــم وزارةالعـــالي

أجــــهزة تخصــصطبيــــــــة

المـــلك جامعــــةسعــود

اإلكلينيكية المختبرات أجهزةأجــز 210

المجتمـع كليـةبالريـاض

األول الدراسى -34الفصل35

Page 2: Clinical Laboratory Equipment MASH 210, A. Eshra, Spring 2013/14, 1 st Semester 1 بسم الله الرحمن الرحيم المملكة العربية السعوديةقسـم العلوم

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Course Instructor

Ayman Elsayed EshraAssistant Prof. Dr. Eng.

Tel. +9664735277 – 401

Room:24A 7-3Office hours: see time tableE-mail: [email protected]

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Textbooks

1- Carr, J. J. & Brown, J. M. “Introduction to biomedical equipment technology” 4th ed., ch.16 pp.427.2- Despopoulos, A. & Silernagl, S. “Color Atlas of Physiology” 5th ed. Thieme, stuttgart . New York, pp.88-105, 2003.3- Health care product comparison system

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Grading & Assessment

Assignments 10%Reports 10%Quizzes 10%Midterm 20%lab 10%Final 40%

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Contents• Blood and its Components• Blood Tests• Centrifuge• Colorimeter• Spectrophotometer• Flam Photometer• Blood cells Counter• Blood Gas Analyzer• Autoanalyzer• Chromatography• Oxygen Concentrator

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Objective

1- Be able to state the purpose of blood.2- Be able to list the components and describe the composition of blood.3- Be able to list and describe blood tests ( cell and chemistry).4- Be able to state the purpose, uses, principle of operation, and maintenance of the following equipment: centrifuge, colorimeter, spectrophotometer, flame photometer, blood gas analyzers (pH, PO2, PCO2), Chromatograph, and autoanalyzers.5- Be able to describe renal physiology, including types of renal failure and the hemodialysis machine operation, safety, and maintenance.

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Medical Laboratory departmentThe medical laboratory department includes facilities, personnel, and

equipment within the hospital or public or private location. The facilities must include a clean, safe surrounding with a special area for sterilization of contaminated blood urine samples and equipment. Since high-volume blood testing occurs in this department , sufficient storage and cleaning area must be designed. In such a situation, the chance of error (misreading or a patient record mixup) is high.

Medical laboratory personnel include equipment operators (medical technologists), supervisors, and physicians. The director of theses facilities is usually a physician.

Equipment contained in the laboratory includes glassware, centrifuges, suction devices, and sophisticated instrumentation, such as colorimeters, spectrophotometers, blood cell and gas analyzers, chromatographs, autoanalyzers, and computerbased record and operation systems.

Recordkeeping is extremely important. This information is used by physicians as an aid in diagnosing disease and imblanced physiological states. Standard cards with printouts of RBC or WBC counts, Hct, MCV, MCHC, and blood chemistry are presented by most clinical Instrumentation.

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Purpose of Clinical laboratory Equipment

The purpose of Clinical laboratory Equipment is to provide a means of measuring required substances and metabolic waste products in blood and urine.

What is blood? Blood is the life-maintaining fluid that circulates through the body's: 1-Heart. 2-Arteries. 3-Veins. 4-Capillaries.

What is the function of blood?Blood carries the following to the body tissues:

1-Nourishment. 2-Electrolytes. 3-Hormones. 4-Vitamins. 5-Antibodies. 6-Heat 7-Oxygen.

Blood carries the following away from the body tissues: 1-Waste matter. 2-Carbon dioxide.

red blood cells

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Where are blood cells made?

Blood cells are made in the bone marrow. The bone marrow is the spongy material in the center of the bones that produces about 95 percent of the body's blood cells.

There are other organs and systems in our bodies that help regulate blood cells. The lymph nodes, spleen, and liver help regulate the production, destruction, and differentiation (developing a specific function) of cells. The production and development of new cells is a process called hematopoiesis.

Blood cells formed in the bone marrow start out as a stem cell. A "stem cell" (or hematopoietic cell) is the initial phase of all blood cells. As the stem cell matures, several distinct cells evolve such as the red blood cells, white blood cells, and platelets. Immature blood cells are also called blasts. Some blasts stay in the marrow to mature and others travel to other parts of the body to develop into mature, functioning blood cells.

Bone marrow [4].

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Human blood consists of about 22 percent solids and 78 percent water. The components of human blood are: Plasma is the fluid portion of the blood in which the blood cells are suspended, including: electrolytes, nutrients, metabolites, vitamins, hormones, gases, and proteins.

1-Red blood cells (erythrocytes) - carry oxygen from the lungs to the rest of the body.

2-White blood cells (leukocytes) - help fight infections and aid in the immune process. Types of white blood cells include:■Lymphocytes. Monocytes. ■ Eosinophils. ■■Basophils. Neutrophils (granulocytes). ■

3-Platelets (thrombocytes) - help in blood clotting.

4-Fat globules.

5-Chemical substances, including:■Carbohydrates. Proteins. ■ Hormones. ■

6-Gases, including:■Oxygen. Carbon dioxide. ■ Nitrogen. ■

What are the components of blood?

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Clear to straw colored (90% water)Solids (8% by mass)Plasma proteins – albumin, globulin, fibrinogenGrowth/protective – hormones, vitamins, antibodies, enzymesInorganic substances – Na+, K+, Cl-, FeOrganic substances – urea waste and protein, fat, glucose nutrientRespiratory gases – O2 and Co2

White blood cells – LeukocytesDefense against bacteria Amoeba – like shaped

Red blood cells – erythrocytesTransport O2 and CO2

Concave disc shaped

Spinning of Blood components

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Composition of Blood

•The blood volume of an adult correlates with his or her (fat-free) body mass and amounts to ca. 4–4.5 L in women (♀) and 4.5–5 L in men of 70 kg BW (♂); table1.

The blood consists of a fluid (plasma) formed elements:•Red blood cells (RBCs): The primary function of red blood cells, or erythrocytes, is to carry oxygen and carbon dioxide. Hemoglobin (Hgb) is an important protein in the red blood cells that carries oxygen from the lungs to all parts of our body. RBCs play an important role in pH regulation.

•White blood cells (WBCs):The primary function of white blood cells, or leukocytes, is to fight infection.

There are several types of white blood cells and each has its own role in fighting bacterial, viral, fungi, and parasitic infections. Types of white blood cells that are most important for helping protect the body from infection and foreign cells include the following:1-Neutrophils. 2-Eosinophils. 3-Lymphocytes. 4-Monocytes.5-Granulocytes.

Seen here are two lymphocyte (left) cells and one neutrophil (right) cell of the human immune system [5].

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White blood cells: •Help heal wounds not only by fighting infection but also by ingesting matter such as dead cells, tissue debris and old red blood cells. •Are our protection from foreign bodies that enter the blood stream, such as allergens.•Are involved in the protection against mutated cells, such as cancer.

•Platelets (thrombocytes):The primary function of platelets, or thrombocytes, is blood clotting.

Platelets are much smaller in size than the other blood cells. They group together to form clumps, or a plug, in the hole of a vessel to stop bleeding.

erythrocyte (left), thrombocyte (center), and leukocyte (right)

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•Blood volume in liters relative to body weight (BW) ♂ 0.041 X BW (kg) + 1.53, 0.047 X BW (kg) + 0.86♀

•Hematocrit (cell volume/ blood volume):♂: 0.40–0.54 : 0.37–0.47♀

•Erythrocytes (1012/L of blood = 106/μL of blood): ♂ 4.6–5.9 4.2–5.4♀

•Hemoglobin (g/L of blood): ♂ 140–180 120–160♀

•MCH, MCV, MCHC— mean corpuscular (MC) mean cell , hemoglobin(Hb), MC volume, MC Hb concentration Fig.1

•Leukocytes (109/L of blood = 103/ μL of blood):3–11 (64% granulocytes, 31% lymphocytes, 6% monocytes)

•Platelets (109/L of blood = 103/ μL of blood): ♂ 170–360 180–400♀

•Plasma proteins (g/L of serum):66–85 (including 55–64% albumin)

Table 1

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Fig.1-C Erythrocyte parameters MCH, MCV and MCHC

Pico- 10-12 Femto- 10-15

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1. Cells

1.1. Red

1.2. white

1.3. Platelets

2. Plasma

2.1. Protein

2.2. Nutrients

2.3. Regulatory and protective substances

2.4. Electrolytes

2.5. Metabolic waste substances

Composition of Blood

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1.1. Red Blood Cells (RBC’s)• No Nucleus• Disc shaped• 120 days life span

Consists of :•Hemoglobin and water•Each RBC contains 4 iron atoms in structure known as the hemoglobin

1.2. White Blood cells (WBC’s)• Amoeba like• Nucleus• 10-14 days life span• 6-10 103 cells/mm3

Purpose: Surround/ swallow invading bacteria and foreign substance to destroy the invader’s effect.

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1.3. Platelets (PLT’s)• Size: 2-3 μm• Normal range: 15-40 104/ μ L• Number 2-8 105 cells/mm3

• Cell fragments• No nucleus• Purpose: Blood coagulation and clotting

2. Blood plasma• Plasma proteins.• Plasma nutrients-energy-storing.• Regulatory and protective substances.• Plasma electrolytes.• Metabolic waste substances.

2.1. Plasma proteins• Albumins• Fibrinogen and prothrombin• Globulin

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2.2. Plasma nutrients-energy- storing• Glucose (blood sugar).• Lipids (fats)• Amino acids (Proteins for tissue growth)

2.3. Regulatory and protective substances• Enzymes• Hormones• Antibodies

2.4. Plasma electrolytes-acid-base• Sodium Na+

• Potassium K+

• Chloride Cl-

2.5. Metabolic waste substances• Urea.• Uric.

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Cell testsChemical tests

BLOOD TESTS

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Hematology Analyzer measures and determines several parameter such as:•RBC’s•WBC’s•Hgb•PLT•Hct: Hematocrit is the volume ratio of red cells to whole blood (Table 1).•MCV : Mean Cell Volume•MCH : Mean Cell Hemoglobin•MCHC : Mean Cell Volume Hemoglobin Concentration•MPV : Mean Platelet Volume•RDW : Red Blood Cell Distribution width

Common hematology tests

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Blood cell tests include the following1-RBC count:

Accomplished manually (diluting a blood sample 100:1 and counting the cells per cubic millimeter by use of a microscope) or automatically (blood cell counting analyzers).

2-WBC count:Accomplished manually (diluting a blood sample 10:1 and counting the

cells per cubic millimeter by use of a microscope) or automatically (blood cell counting analyzers).

3-Hematocrit (Hct):Percentage of total blood volume that is solid (WBCs volume is negligible).

This is measured by spinning a blood sample in a test tube and optically observing the percentage of packed RBCs. It normally ranges from 45% to 55%.

4-Mean cell (corpuscular) volume (MCV): Average volume of an RBC measured by a value based on the RBC count

(number per mm3). This volume is measured in femtoliters (10-15 L)

MCV = Hct / RBCThese testes aid in diagnosing anemia and other blood disorders and certain cancers of the blood; to monitor blood loss and infection; to monitor a patient's response to cancer therapy, such as chemotherapy and radiation.

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5-Platelet count: To diagnose and/or monitor bleeding and clotting disorders.

Accomplished automatically by a blood cell analyzer.

6-Mean cell hemoglobin (MCH):The proportional mass of RBC/100 mL of the total number of RBCs is

expressed as:

This value is indicated in picograms (10-12 g), measured by lysing RBCs (breaking their membranes) to release hemoglobin (27–32pg). Acid hematin or cyanmethemoglobin can be generated by hemoglobin chemical reaction.The resultant value is measured by a colorimeter and normally indicates 32 % to 36 % color index.

7-Mean cell hemoglobin concentration (MCHC):Hemoglobin color concentration measured by lysing RBCs (breaking their

membranes) to release hemoglobin.The resultant value is measured by colorimeter and normally indicates 32 % to 36% color index.

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1-pH 2-Glucose 3-Amino acids4-Urea waste 5-Uric acid 6-Cholesterol

Blood Chemical Tests

Other Blood Tests1- Blood serological tests:

They involve testing for agglutination (clumping) of cells due to the addition of antigens (bacterial toxins) to blood serum. This occurs following the reaction of a specific antibody produced by WBCs in response to the specific invader.

2- Blood bacteriological testes :They include growth of blood bacteria in a petri dish with appropriate

nutrients.

3- Historical tests:They are studies of small, thin tissue samples under the microscope.

Specimens are obtained by cutting tissues with a precision slicer known as a microtome.

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Collecting Labeling

Documenting Processing

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Analyzing Results

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Blood transport heat

References1. http://www.medicine.mcgill.ca/physio/vlab/bloodlab/eryfrag2_n.htm2. http://labtestsonline.org/lab/photo/blood1/?start=33. http://anthro.palomar.edu/blood/blood_components.htm4. http://www.chw.org/display/PPF/DocID/21846/router.asp5. http://www.blood.co.uk/about-blood/components/